DRUG-RELATED PROBLEM | ACTION PLAN | MONITORING |
---|---|---|
Low BP secondary to
|
| BP (target of 120/60 mm Hg to 150/80 mm Hg) |
Dizziness, light-headedness, fatigue, and dry mouth can be caused by
|
| Dizziness, light-headedness, fatigue, dry mouth Nausea, vomiting, or bloating with stopping metoclopramide Sleep pattern Worsening of watery, itchy eyes Worsening of vertigo or dizziness |
Risk of exacerbation of parkinsonism increased with metoclopramide |
| Nausea, vomiting, or bloating |
Unclear value of rosuvastatin (no apparent CVD or cerebrovascular disease; patient has history of hemorrhagic stroke for which statin secondary prevention effectiveness is controversial) |
| NA |
Patient’s nausea
|
| Worsening of vertigo or dizziness Nausea Fatigue or dry mouth Eye itchiness and wateriness Rebound heartburn (2–4 wk) |
Patient’s low mood
|
| Heart rate, angina with taper BP (target of 120/60 mm Hg to 150/80 mm Hg) Improvements in mood, anxiety, interest in social activities Improvements in sleep and insomnia, dizziness, etc, with antidepressant initiation |
Patient at risk of fracture with falls (taking 150 mg of risedronate monthly and vitamin D) and would benefit from addition of calcium | Add up to 1000 mg of calcium carbonate antacid twice daily (check dietary intake) | GI side effects, constipation |
Itchy and watery eyes
|
| Eye itchiness and wateriness |
Routine blood glucose monitoring not needed (diet controlled) | Stop routine blood glucose tests | NA |
AF—atrial fibrillation, ASA—acetylsalicylic acid, BP—blood pressure, CAD—coronary artery disease, CVD—cardiovascular disease, GI—gastrointestinal, MI—myocardial infarction, NA—not applicable.
↵* Metoclopramide increases levodopa bioavailability; stopping it might reduce levodopa effect. This might then be balanced by reduced metoclopramide exacerbation of Parkinson disease symptoms.